Botulinum Toxin A Versus Bilateral Medial Rectus Recession for Partially Accommodative Esotropia: A Systematic Review and Meta-analysis

PURPOSE: To perform a systematic review and meta-analysis comparing the efficacy of botulinum toxin A (BTX-A) and bilateral medial rectus recession (BMR) surgery for partially accommodative esotropia (PAET). METHODS: statistics. The analysis was performed using R software version 4.3.2. The Risk of Bias Summary for Non-randomized Studies tool was used to assess the risk of bias. RESULTS: = 0%). All studies accounted for heterogeneity in the leave-one-out sensitivity analysis. Two studies were judged as moderate risk of bias and two as serious. Assessment of Grading of Recommendations Assessment Development and Evaluation resulted in moderate certainty in the outcome of motor success rates. CONCLUSIONS: BTX-A might be a good alternative to BMR in patients with PAET. Randomized controlled trials with larger sample sizes and longer duration of follow-up are needed. Studies should also focus on sensory outcomes in addition to motor outcomes.